Hello, I am a 21 year old , 6'3 175 pound male. I am under extreme stress however, and I am worried about how it will affect my heart. I do not smoke, drink or do drugs of any kind and I take xanax daily. My blood pressure levels are usually very average, the highest I have ever had is 155/86 and I was very stressed out about it. BUt It has come back down now that I go to the doctor. My cholesterol levels are total 185 and HDL is high and LDL is 116. Triglycerdies are very low, (48). I just want to know if the stress/anxiety can hurt me or not, I am making tremendous strides with medicine and counseling. Can stress give me a heart attack despite these average numbers? Please I am desperate. Thanks. I do exercise at least 2 times a week.

You do sound like an anxious fellow, so I can empathize with you. Anxiety and stress are some of the most unpleasant emotions we can experience, and they also cause far more dramatic and easily measured symptoms than the opposite, which would be depression or dysthymia. However, except in the most rare and extreme cases (usually where significant heart disease was also already long-established) these emotions will not damage your body, at least not in the short term. There is some evidence that over the long haul there may be some evidence to support them causing or at least assisting in the development of heart or kidney disease and high blood pressure. But this causal relationship will require more study, and what evidence there is suggests that it may happen to people who are extremely anxious over a period of decades. You aren't there yet.

Anxiety first of all robs us of the ability to fully enjoy our lives, and that alone is sufficient reason to get it fixed. This is a personal challenge, and one which often responds best to longer-acting anti-anxiety medications (Xanax is popular because it is fast-acting, but its effect is also rather brief, so it's not the best therpeutic approach, though it does make an excellent "rescue" drug for panic attacks or really disabling spells of acute anxiety). Clonazepam (brand name Klonopin) is highly regarded by some psychopharmacologists, although the SSRI family of antidepressants is currently more popular. These latter do have the undesireble potential of actually worsening anxiety in a small subgroup of patients, however, and at least one well known specialist in the treatment of anxiety and panic disorder relies heavily on clonazepam as the first line of treatment, combined with cognative therapy (a sort of behavioral modification psychotherapy that is not open-ended like general "talk" therapy for more subtle conditions). I'd strongly suggest looking into a change of medication as well as CT. I'd also look into meditative and relaxation techniques to help quiet yourself as much as possible. I know you've probably tried to talk yourself into being more calm, but the trick there is that it is like telling one's self not to think of, say, an elephant. Soon as you've decided what you're not supposed to be thinking of, sure enough you can't get it out of your mind, because, after all, it is the target of the exercise! So CT, a longer-acting, longer-term medication, and a look into some serious meditative techniques would probably be the way to go.

Your blood pressure, while higher than desireble when it does get up there, is not surprising or unusual for an anxious person. While it does you no good, over short periods of time it also usually will do no harm, either. If it should get much above what you've quoted here, you might have to be put on a beta blocker, which is another possibility for the person who suffers especially from situational anxiety, such as the fear of public speaking, flying, etc. This family of drugs does lower blood pressure, slows the heart rate, and often has a generalized relaxing (or overall slowing) effect on patients, and is usually reserved for heart patients and people with consistently and dangerously elevated BP, but some doctors will prescribe it for certain selected anxious patients.

Anxiety is an awful thing to deal with, and stress and anxiety of course go hand in hand. Anything you can do to reduce your concern over things you cannot control will help with this, as well as looking into the suggestions I've made, and perhaps discussing them with your doctor.

You have a lot of years to enjoy -- or not! I certainly hope you are able to start enjoying them more fully with less stress and anxiety. They add nothing but take away a lot from our enjoyment of life.